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* Responsible for performing the accurate and detailed medical review of complex advertising and promotional materials and non-promotional materials .
* Provides timely and accurate reviews of promotional materials in accordance with established policies and practice standards, including regulatory guidelines to meet customer needs.
* Ensures deliverables convey a clear and appropriate ...

Overview
Empower AI is AI for government. Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct path for meaningful transformation. Headquartered in Reston, Va., Empower AI leverages three decades of experience solving complex challenges in Health, Defense, and Civilian missions. Our proven Empower AI Platform® provides a practical, sustain...

Grow Healthy
If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a ...

Valor Healthcare is looking for a Medical Reviewer to join our team on a PRN or per diem basis supporting arbitration of Medicare/Medicaid evaluations.
Schedule: This position is typically 4 hour a week with flexible hours depending on candidate's availability. Although, there may be a few instances where meetings may take place during the work day.
The focus of Risk Adjustment Data Validat...

Summary
We are currently hiring for a Senior Medical Reviewer to join CGS, a Celerian Group Company and subsidiary of BlueCross BlueShield of South Carolina. In this role you will Act as Team Lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving direction/guidance/training t...

Job Description Summary:
The US Medical Information Reviewer conducts the medical and scientific accuracy review of materials which have been submitted through PTC’s global medical, legal and regulatory (MLR) and medical quality check (MQC) processes for marketed products and investigational drugs; contributing to the production of high quality and impactful pharmaceutical promotion and scie...

Summary
We are currently hiring for a Senior Medical Reviewer to join CGS, a Celerian Group Company and subsidiary of BlueCross BlueShield of South Carolina. In this role you will Act as Team Lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving direction/guidance/training t...

Summary
We are currently hiring for a Senior Medical Reviewer to join CGS, a Celerian Group Company and subsidiary of BlueCross BlueShield of South Carolina. In this role you will Act as Team Lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving direction/guidance/training t...

Summary
This is reporting and research position is part of our Palmetto GBA Medicare Part A Post-pay Audit Team. If you are an analytical RN who enjoys delving into numerical and statistical data, this role may be a good fit for you. Must be familiar with Excel or other spreadsheet software and be able to create worksheets with formulas and short cuts. You will create new reports, as we...

Summary
This is reporting and research position is part of our Palmetto GBA Medicare Part A Post-pay Audit Team. If you are an analytical RN who enjoys delving into numerical and statistical data, this role may be a good fit for you. Must be familiar with Excel or other spreadsheet software and be able to create worksheets with formulas and short cuts. You will create new reports, as we...

Job Details
Level: Experienced Job Location: California Office - Roseville, CA Position Type: Full Time Education Level: Bachelor's Degree Salary Range: $75,000.00 - $85,000.00 Salary/year Travel Percentage: None Job Shift: Day Job Category: Insurance
Medical Itemized Bill Reviewer (IBRL-1 Analyst)
Who We Are
Machinify is a leading healthcare intelligence company ...

Company Overview
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership ...

Summary
This is reporting and research position is part of our Palmetto GBA Medicare Part A Post-pay Audit Team. If you are an analytical RN who enjoys delving into numerical and statistical data, this role may be a good fit for you. Must be familiar with Excel or other spreadsheet software and be able to create worksheets with formulas and short cuts. You will create new reports, as well as m...

Current Employees:
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The Concurrent Quality Reviewer of our hospital reviews documentation in the electronic medical...

Summary
CGS is looking for Registered Nurses to join our DME (Durable Medical Equipment) Medicare Medical Review team. Selected candidates will be reviewing medical records to determine medical necessity and eligibility under Medicare guidelines. This administrative role will need strong clinical and computer skills. No regular patient/provider contact. Excellent for those individuals l...